Exit Interview Form

We would appreciate you taking about 8-10 minutes to answer the following questions as
honestly as possible. Your responses are treated as confidential. We believe that the
information is of vital importance and will assist us analyzing our employee retention and
turnover.

Name:
Department:
Position:
Date of Joining:

1. What prompted you to seek alternative employment?

[ ] Type of Work [ ] Quality of Supervision

[ ] Compensation [ ] Work Conditions
[ ] Lack of Recognition [ ] Family Circumstances
[ ] Company Culture [ ] Career Advancement Opportunity
[ ] Business/Product Direction [ ] Other:

2. Before making your decision to leave, did you investigate other options that would
enable you to stay?

[ ] Yes [ ] No

If Yes, describe:

3. What did you think of your supervision in regard to the following?

Almost
Sometimes Never Comments
Always
Demonstrated fair
[] [] []
and equal treatment
Provided
recognition on the [] [] []
job
Developed
cooperation and [] [] []
teamwork
Encouraged/listened
[] [] []
to suggestions
Resolved complaints
[] [] []
and problems
Followed policies
[] [] []
and practices
4. How would you rate the following in relation to your job?

Excellent Good Fair Poor Comments

Cooperation
within your [] [] [] []
department
Cooperation with
other [] [] [] []
departments
Communications
in your [] [] [] []
department
Communications
within the
[] [] [] []
company as a
whole
Communications
between you and [] [] [] []
your manager
Morale in your
[] [] [] []
department?

Job Satisfaction [] [] [] []

Training you
[] [] [] []
received

Growth Potential [] [] [] []

5. Was your workload usually:

[ ] Too great
[ ] Varied, but all right
[ ] About right
[ ] Too light

6. How did you feel about your salary and the employee benefits?

[ ] Excellent
[ ] Good
[ ] Fair
[ ] Poor
Comments:
7. Are there any other benefits you feel should have been offered?

[ ] Yes [ ] No

If Yes, what?

8. How frequently did you get performance feedback?

9. What were your feelings about the performance review process?

10. How frequently did you have discussions with your manager about your career goals?

11. What did you like most about your job and/or this company?

12. What did you like least about your job and/or this company?

13. What does your new job offer that your job with this company does not?
14. Why is the new job/company better?

15. Do you have any suggestions for improvement? Have you raised them in the past?

16. Would you recommend this company to a friend as a place to work?

[ ] Yes, without reservations [ ] Yes, with reservations [ ] No

17. Additional comments about your job or this company

Thank you for your feedback!